Individual
LEONELA C BASTIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 671-3000
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 671-3000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
125085262
IL
Other
Enumeration date
07/21/2022
Last updated
06/20/2025
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